Chemotherapy 2

Question 1

Temozolomide MOA

Answer 1

Bioactivated into diazomethane which methylates DNA

Question 2

Temozolomide Thera use

Answer 2

Brain (astrocytoma), Melanoma

Question 3

Temozolomide side effects

Answer 3

BMS (thrombocytopenia, neutropenia), HA, Fatigue

Question 4

Temozolomide MOR

Answer 4

Alkyl guanine transferase

Question 5

Cisplatin MOA

Answer 5

Forms DNA adducts which inhibit DNA replication & transcription & lead to breaks & miscoding, N7 guanine

Question 6

Cisplatin Thera use

Answer 6

Testicular, Ovarian, Cervix, Bladder, N/SCLC

Question 7

Cisplatin side effects

Answer 7

BMS, Peripheral neuropathy, Ototoxicity, Hypersentivity rxn (Anaphylaxis) Nephrotoxicity (decrease w/ NS hydration, diuresis, Amifostine: cytoprotective)

Question 8

Cisplatin MOR

Answer 8

Loss of mismatch repair (MMR) ->no apoptosis

Question 9

Methotrexate MOA

Answer 9

Inhibition of Dihydrofolate reductase: decrease DNA, RNA synthesis, S phase specific

Question 10

Methotrexate therapeutic use

Answer 10

ALL, CNS leukemia (IT), GTN, Breast, NHL

Question 11

Methotrexate side effects

Answer 11

Myelosuppression, pneumonitis, mucositis, hepatoxicity, nephrotoxicity, teratogenesis, meningismus (IT)

Question 12

Methotrexate MOR

Answer 12

DHFR gene amplification

Question 13

Pyrimidine analogs MOA

Answer 13

S-phase specific

5-FU → 5-F-deoxyuridine monophosphate, Inhibitor of thymidylate synthase -> decreases DNA synthesis

Question 14

Pyrimidine analogs therapeutic use

Answer 14

5-FU: Colorectal, breast, gastric, pancreatic, esophageal

Question 15

Pyrimidine analogs side effects

Answer 15

5-FU, Capecitabine: N/V/D, Alopecia, Myelosuppression, Hand & Foot syndrome

Question 16

Purine analogs MOA

Answer 16

S-phase specific

6-MP → 6-thioguanine nucleotides, Incorporated in DNA & RNA, Cytotoxicty by decreased RNA & DNA synthesis

Question 17

Purine analogs Therapeutic Uses:

Answer 17

6-MP: ALL

Question 18

Purine analogs side effects

Answer 18

6-MP : Myelosuppression, N/V/D, Hepatotoxic

Question 19

Vincristine MOA

Answer 19

Block cells in mitosis, M-phase specific, bind specifically to tubulin & block its ability to polymerize into microtubules

Question 20

Vincristine Therapeutic Uses

Answer 20

HD, NHL, Brain, ALL

Question 21

Vincristine Side Effects

Answer 21

Fatal (IT, seizures, coma), Alopecia, Myelosuppression, Neurotoxicity (paresthesia, PN), Constipation (ileus), SIADH

Question 22

Vincristine MOR

Answer 22

MDR, MRP, Tubulin mutations

Question 23

Paclitaxel MOA

Answer 23

Bind to microtubules & antagonize the disassembly, causes arrest in mitosis, M phase specific

Question 24

Paclitaxel Thera uses

Answer 24

Ovarian, N/SCLC, Breast, H/N, KS

Question 25

Paclitaxel side effects

Answer 25

Myelosuppression, Peripheral neuropathy, Mucositis (ulcers), Hypersensitivity (50:50 Etoh:Castor oil)

Question 26

Paclitaxel MOR

Answer 26

MDR, Tubulin mutations